Less Chemotherapy for Breast Cancer: The TAILORx Results

We teach you about the TAILORx clinical trial results and how this information may save many women in the future from chemotherapy.

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Questions for your Breast Surgeon and Medical Oncologist:

*Do I qualify for an Oncotype DX genomic test?
*If so, will you order genomic testing for me?
*What if I have an "Intermediate" result?
*Do you follow the "TAILORx" trial recommendations?
*Would you order a genomic test before I see a medical oncologist?

What does the TAILORx Clinical Trial results mean to me?

On June 3rd, 2018 the results of the largest breast cancer trial reported results that help us better determine who MAY benefit or MAY NOT benefit from chemotherapy in early stage, favorable breast cancers. The results help patients and physicians better interpret the results from the genomic assay, Oncotype DX, which is commonly used in the United States. The trial concludes that most patients with an "Intermediate Recurrence Score" result may avoid chemotherapy. The results were also released for publication by the New England Journal of Medicine.

Journal Article Link:
https://www.nejm.org/doi/full/10.1056/NEJMoa1804710

Video Outlining the TAILORx Clinical Trial:
https://www.youtube.com/watch?v=orwPgT0ZP_0&t=14s

What is a genomic test?

These sophisticated tests are performed on a small sample of cancer tissue in appropriate patients with early stage breast cancer. Genomic tests are usually ordered after surgery when the pathology report is finalized. It measures unique aspects of the tumor to determine if a patient will benefit from chemotherapy in addition to hormonal therapy. Such “genomic assays” developed over the last decade are a dramatic advance in breast cancer care. The Oncotype DX assay by Genomic Health Inc. is the most utilized genomic assay of those available in the United States.

Who should consider a genomic test?

Patients who have small “Estrogen receptor positive” (ER+) and “HER2 receptor negative” (HER2-) tumors and no evidence of cancer in their lymph nodes may benefit from an Oncotype DX assay. The purpose of this test is to better identify people who do and do not benefit from chemotherapy. The decision to undergo chemotherapy is a complicated one. Your medical oncologist will examine multiple factors to help determine if you will benefit from chemotherapy. The NCCN Guidelines, listed in the website links below, outline in much greater detail recommendations for the use of genomic tests. An Oncotype DX test can be instrumental in this decision for many patients.

You may qualify for a Genomic Assay if…

You have early stage cancer (Stage I or II)
Your tumor is Estrogen receptor positive (ER+)
Your tumor is Her2 receptor negative (HER2-)
No cancer was found in your lymph nodes
You are willing to consider having chemotherapy
You are healthy enough to undergo chemotherapy

How is chemotherapy tailored to patients?

Genomic breast cancer tests are a leap forward in our ability to “look inside” breast cancer cells. Sophisticated breast cancer care is based upon the principle of providing maximal benefit from the least toxic therapy. Newly diagnosed breast cancer patients deserve the best information available to decide whether they need chemotherapy. Take our video lesson on “Will I Need Chemotherapy?“ (here) to understand the general concepts. Genomics is a promising and rapidly developing field.

Take Home Message:
Make sure to ask both your breast surgeon and medical oncologist if a genomic assay might play a role in your treatment decisions. For appropriate patients, these tests should be considered only one piece of the many “pieces of the puzzle” in deciding treatment decisions about chemotherapy and hormonal therapy.

Видео Less Chemotherapy for Breast Cancer: The TAILORx Results канала Breast Cancer School for Patients